Varicose Veins

Understanding Circulation

Veins carry blood back to the heart. When we are standing, blood returns against the force of gravity. Pumping blood to the heart largely depends on calf and thigh muscle contractions and this is why walking helps the circulation. Valves in leg veins normally prevent blood from returning down the leg under gravity.

Most of the normal circulation is through the deep veins. Two large superficial veins join the deep veins - the great saphenous vein from the groin and the small saphenous vein from the back of knee. Superficial and deep veins are connected in the thigh and calf through communicating veins called perforators. Saphenous veins are usually hidden deeper under the skin. The surface varicose veins that are obvious are tributaries of the saphenous veins.

Causes of Varicose Veins

Veins weaken and stretch so that valves lose their function to become "incompetent". Gravity then causes blood to "reflux" down the leg. High pressure within the veins causes them to further enlarge. Fortunately, the process usually affects accessible superficial veins and not hidden deep veins. The reason why larger veins weaken and why reticular and spider veins develop are not known.

Varicose veins occur in both males and females.

Heredity may be a factor as many patients have parents who were also affected but this may simply be because the condition is so common.

Pregnancies, obesity and prolonged standing are the only factors known to accelerate progression of varicose veins.

Oral contraceptives and hormone replacement therapy have not been shown to cause varicose veins to worsen.

Symptoms

Varicose disease affects some 50% of the population increasing in prevalence with age. Some patients seek treatment because of appearance which prevents them from exposing the legs. Others seek treatment because of:

throbbing,

aching,

tiredness,

heaviness,

cramps,

burning,

itching or

restless legs.

Symptoms can occur with small veins. However, symptoms in the legs may be due to other conditions and not to varicose veins. Further problems can include: